AMA Seeks to Get Meaningful Use Back on Track

On October 14, the American Medical Association (AMA) issued a statement setting out their blueprint to improve the Meaningful Use program ahead of the publication of the proposed rule for Stage 3 of the program.

In this statement, AMA President Dr Robert Wah (and I should declare an interest here, Dr Wah is also CSC’s Chief Medical Officer) says, “While more than 78 percent of physicians are using an EHR, thousands have not participated in the Meaningful Use program.”

Good news and bad news. A large majority of physicians have tools that should help them deliver better care to their patients. However, many are not showing that “they are meaningfully using their EHRs by meeting thresholds for a number of objectives.” That means physicians are missing out on payments. More importantly it could also mean that patients aren’t getting the benefits we all expected from EHRs – we don’t know for sure as they’re not participating in the program.

You see a pattern with some large technology projects. They start with a vision for change that’s intended to make things better. They finish as an implementation project that’s become an end in itself, is mired in deadlines and compromises, and where success is judged by measures some distance from that original vision.

As I understand it, “Meaningful Use” was an attempt to get away from that. The expected benefits were well-articulated, and the incentives were intended to be lined up directly with achieving those benefits. It’s an enlightened approach, no doubt informed by real-world experience of complex change management programs.

Dr Wah and the AMA are better qualified than most (and particularly than me) to comment on the progress of the Meaningful Use program. So, if they’re raising concerns, we need to take notice. The blueprint for change the AMA has set out is clear and well thought through, and will hopefully have a positive impact for physicians.

Particular areas that resonate are the suggestion that, “Physicians should not be required to meet measures that are not improving patient care,” and the call for an increased focus on interoperability.

The first of these sounds obvious, but reminds me of that IT project which lost its connection with the original vision. It’s always good to be reminded just what the point is. The second is a more esoteric technology angle, but is profoundly important. One of the phrases Dr Wah uses often is “better information for better decisions.” Interoperability means that the raw data underpinning that “better information” can more readily follow the patient round the system – which is the key benefit of technology.

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